Descriptive study on the clinical profile and demography of patients with chronic folliculitis of leg attending a tertiary referral center

Abstract

Objectives: The objectives are as follows: (1) To document the clinical profile and demography of patients attending a tertiary referral institution with chronic folliculitis of leg and (2) to document the bacteriological profile of pustular lesions of chronic folliculitis. Materials and Methods: After obtaining clearance from institutional research and ethics committees, consecutive patients who attended our tertiary care center with clinically diagnosed chronic folliculitis of the leg from December 1, 2016, to November 30, 2017, were included in this cross-sectional study. The data regarding patient characteristics and clinical profile of disease were collected using a preset pro forma. Pus culture and sensitivity study was carried out in all patients who had pustules at presentation. The association between duration of disease and extent of disease and duration of disease and clinical grading was evaluated by Pearson’s Chi-square analysis. Results: The study population comprised 39 (78%) males and 11 (22%) females with male to female ratio of 3.5:1. Study participants ranged in age from 16 to 67 years. In 15/24 (62.5%) patients who manifested pustules, pus culture isolated pathogenic bacteria, Staphylococcus aureus, sensitive to cloxacillin in 14 (58.3%) and methicillin-resistant S. aureus in one (4.2%). Limitations: A study conducted in a tertiary referral center not reflecting the disease profile in the community was the major limitation. Conclusion: Staphylococcus aureus sensitive to common antibiotics like cloxacillin being the most common pathogen isolated from pustular lesions signifies the need for more prospective studies with a large sample size to evaluate the role of environmental factors and individual’s immune system in maintaining the inflammation in chronic folliculitis of the leg.

Dermatitis Cruris Pustulosa et Atrophicans: Scarring Alopecia Beyond Scalp Hair

“…Accordingly, season variations have been described, with summer and monsoon (humid and torrential rainfalls) exacerbations [7, 13, 27]. However, winter aggravation has also been mentioned [11, 16]. Occupational exposure to other possible irritants beyond saltwater and sea sand has been pointed out by Kumarasinghe and Kumarasinghe [22], namely, cement, mud, plants, fertilizers, and wood dust.…”

“…The disease was also described in 1 patient in North America, under the designation of "epilating folliculitis of the glabrous skin" and "lupoid sycosis of the legs" [10]. More recently, it has been mentioned as "chronic superficial folliculitis" [11]. These terms reflect the clinical features of the disease, which will be mentioned under the term "Dermatitis Cruris Pustulosa et Atrophicans" along the manuscript.…”

“…The reported prevalence varies between 0.4 and 4.8% [6,7,14,26], 3-4% in south India and 2.9% in Sri Lanka [22]. However, data should be regarded as an estimated mirror of incidence [1][2][3][4][5][6]11] in the community, as only hospital-based data (outpatient clinics) are available. No definite cases of DCPA outside the tropical humid climates have been described after Miller's [10] original report in 1961 in North America, particularly in Europe (Table 1).…”

“…DCPA is nowadays regarded as a type of chronic folliculitis often limited to the lower limbs of young adults, mostly in the second to third decades. Sex predilection has varied from male to absent (Table 1) [1][2][3][4][5][6]11]. Duration varies from a few months to 22 years, with most reports around 1-2 years [6,11].…”

“…Sex predilection has varied from male to absent (Table 1) [1][2][3][4][5][6]11]. Duration varies from a few months to 22 years, with most reports around 1-2 years [6,11].…”